Ancylostoma ceylanicum hookworm infection in Japanese traveler who presented chronic diarrhea after return from Lao People's Democratic Republic
Introduction
Traveler's diarrhea is the most frequently encountered travel-related illness and can be caused by a wide range of pathogens, including bacteria, viruses, and parasites. Hookworms are one of the most common parasitic nematodes that infect both humans and animals, and such infection is an etiological factor in chronic diarrhea [1]. The two primary species of hookworm found in humans are Ancylostoma (A.) duodenale and Necator (N.) americanus, which infect approximately 600 million individuals throughout the world [2]. Furthermore, A. ceylanicum, A. braziliense, and A. caninum are hookworms found in cats and dogs that are also able to cause zoonotic disease in humans, such as creeping eruption, eosinophilic enteritis, localized myositis, erythema multiforme, and ophthalmological manifestations. Among these zoonotic hookworms, A. ceylanicum is known to cause patent infections in humans, and natural infection with that seems to be endemic and widely distributed throughout Asian countries, especially in southeast Asia [3], [4], [5], [6], where a high prevalence of infection with A. ceylanicum has been reported in domestic stray as well as community raised dogs and cats. As a result, this zoonotic hookworm is emerging as a commonly encountered human hookworm in cases seen in southeast Asia [7], [8]. We recently treated a case of A. ceylanicum hookworm infection in a Japanese patient who returned from a visit to Thailand and Lao People's Democratic Republic (PDR), and was presented with abdominal pain, vomiting, and diarrhea with eosinophilia.
Section snippets
Case
In October 2015, a 47-year-old man with no medical history visited us because of intermittent diarrhea with extreme eosinophilia. In July, he had visited Bangkok, Thailand and its suburbs for 2 weeks, then went on to Lao PDR and spent 4 weeks in a rural Laotian village near Vang Vieng. On August 20, day 24 of living in the village, he experienced an abrupt onset of fever, abdominal pain with watery diarrhea, and vomiting, and required treatment for dehydration by a local doctor. The symptoms did
Discussion
We encountered a patient with diarrhea and eosinophilia upon return to Japan after travelling to southeast Asian countries (Thailand, Lao PDR), which were proven to be caused by A. ceylanicum infection. This hookworm is one of the most common species infecting canines and felines in Asia, and reported to be highly prevalent among domestic stray and community raised dogs and cats in India [10], Thailand [3], [11], Malaysia [6], [12], [13], Indonesia [14], and Laos [15]. Although the 2 species of
Conflicts of interest
The authors have no conflicts of interest to declare in association with this study.
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